Rodwin MA.
AHSR FHSR Annu Meet Abstr Book. 1994; 11: 145.
School of Public and Environmental Affairs, Indiana University, Bloomington 47405.
PROBLEM AND OBJECTIVES. To compare the use of traditional quality control strategies with medical consumerism and political movements that aim to promote accountability (e.g., patients' rights, women's health, and disability rights movement). DATA AND METHODS. Analysis of literature on medical consumerism, patients' rights, and women's and disability rights movement. RESULTS AND CONCLUSION. This paper contrasts the prevailing model for assessing and improving medical care--the quality of care paradigm--with an alternative approach--the patient accountability paradigm. The first approach is technocratic: it measures and promotes the quality of medical care through technical and objective means. It relies on outside experts, analysis of data and protocols, and impersonal judgements to guide decisions. The second approach fosters ways to guide physicians and providers and subjects them to patient control through the use of political voice and exit. It enlists the participation of patients and consumers to evaluate and change the medical care system and to promote patients' rights and choices. This paper examines the experience of the patients' rights movements, the women's health movements, the disability rights movements, and medical consumerism. These movements all identified problems that were not even noted by professionals using technical measure of quality. And these movements used a combination of political voice and market exit which led to improvements in quality of care. Despite the importance of technical measures of quality, relying on them alone slights the considerable complementary contributions of the accountability approach. The challenge for the future is to incorporate political accountability to patients and the perspectives of patients into an assessment system that over-emphasizes approaches. IMPLICATIONS FOR AUDIENCE: Political voice and consumer exit should be tapped to promote organizational accountability and improve quality of care.
Publication Types:
Keywords:
- Community Health Planning
- Delivery of Health Care
- Disabled Persons
- Female
- Health
- Human Rights
- Humans
- Patient Rights
- Quality Assurance, Health Care
- Quality of Health Care
- Social Responsibility
- Women's Health Services
- ethics
- hsrmtgs
Other ID:
UI: 102212216
From Meeting Abstracts